FORM 15-A

Carbon Dioxide Fire Extinguishing Systems

General Information
Date: ________ Inspector: _______________________ System: _____________________________
Location: _______________________________________________________________________________

CO2 system manufacturer: ______________________________________________________________________________

Detector manufacturer: _________________________________________________________________________________
Control panel manufacturer: _____________________________________________________________________________
Date system installed: ___________________________________________________________________________________

Room or area designation: ______________________________________________________________________________

Volume protected: ■ Above ceiling
■ Below raised floor
■ Between floor and ceiling
System concentration: ■ 50% ■ 65% for ________ minutes
■ 75% ■ Other ________%
Weight of CO2 agent with cylinder: ________________
Weight of cylinder (tare weight): ________________
Weight of CO2 agent: ________________
Normal pressure (super pressure): ________________
Detection system: ■ Ionization-type smoke detectors
■ Photoelectric-type smoke detectors
■ Rate-of-rise heat detectors
■ Fixed-temperature heat detectors
■ Rate-compensation heat detectors
■ Other ___________________________________________________
Type of detection for CO2 system operation: ■ Single zone
■ Two zones (cross-zoned)
■ Two detectors on any zone
■ Other ___________________________________________________

Notes

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